Let's stop “eating our young”

Abstract

Bullying, incivility, and workplace violence are pervasive problems within the nursing profession, resulting in a toxic work environment, a variety of related health issues, increased costs to healthcare organizations, and compromises in patient safety. Bullying, incivility, and workplace violence can occur in all areas of nursing.1 Each of these pervasive challenges can take many forms. Here are a few illustrative scenarios: A new RN is struggling with his patient assignment. When he requests help from his more experienced coworker, she replies that she is “too busy” with her own assignment to assist, even though she knows he has been struggling. Her denial of assistance is accompanied by a comment such as, “I am just as busy as you are. Keep trying, and you will eventually figure it out. That’s how I learned when I was a new nurse.” During shift change, an experienced RN rolls her eyes and mutters under her breath as she reads the assignment board that was created by a lessexperienced, younger RN for her first time. She comments within earshot of the new nurse, “These Millenials have no idea what they are doing.” A newly hired RN who was once unlicensed assistive personnel (UAP) has noticed that other RNs on the unit do not seem to trust her judgment and repeatedly tell her what she is doing is wrong. Instead of providing insight into strategies for improved performance, her nurse colleagues simply turn and walk away when she tries to explain why she selected a certain approach. These examples demonstrate the critical importance for all members of the nursing profession to actively examine and combat the effects of bullying, incivility, and workplace violence in the healthcare environment; establish methods for identification of and disciplinary consequences for bullying behavior; and conduct an examination of the related financial burdens of attrition for hospitals and other healthcare agencies. Nurse manager promotion of zero-tolerance policies for workplace violence, including bullying, and increased education is necessary for a cultural shift within contemporary nursing policy and practice. Bullying, incivility, and workplace violence defined Workplace bullying has been discussed in the nursing literature for almost 20 years. The phenomenon is often referenced by the expression “Nurses eat their young.”2 In spite of the widespread recognition of this damaging behavior toward new, young, or inexperienced nurses, the problem persists. One definition of workplace bullying is repeated, health-harming mistreatment of one or more persons by one or more perpetrators. It is abusive conduct (threats, humiliation, intimidation, or verbal abuse) that causes work interference.3 Bullying may also be referred to as horizontal violence, lateral violence, or relational aggression.4 Bullying, abuse, conflict, incivility, and lateral violence of any form make up the broader phenomenon of workplace incivility.5 All of these terms describe forms of psychological and social harassment brought about by one nurse or a group of nurses (also known as “mobbing”) using covert and overt behaviors against another nurse or group of nurses. Mobbing is executed by a leader, who can be a manager, coworker, or subordinate. The leader rallies others into a